Purpose During the posteromedial approach to the tibial plateau fracture (TPF), pes anserine is generally retracted. However, pes anserine detachment could provide a better fracture site exposure. Even so, the general conception is that the latter could negatively affect flexor muscle strength. We aimed to evaluate the effect of pes anserine detachment on the flexion force and functional outcomes of TPF with posteromedial involvement. Methods In this retrospective-prospective cohort study, 22 TPF patients with Schatzker type IV who were managed with posteromedial approach and pes anserine detachment were included. The knee flexion force was measured 12 months after the surgery at several angles of flexion (30°, 60°, and 90°) and rotations (internal and external). The International Knee Documentation Committee (IKDC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to assess knee function. A visual analog scale (VAS) was used to measure knee pain. Results The mean strength of the knee flexor muscle was not statistically different between the involved and non-involved sides at 30°, 60°, and 90° knee flexion, and also at the internal and external rotation. The mean IKDC score of the patients was 81.6 ± 7.8. The mean KOOS score of the patients was 82.2 ± 9.1. The mean VAS for pain was 2.4 ± 1.8. The mean knee range of motion was 124 ± 10.5°. Conclusion Pes anserine release and re-attachment in the posteromedial approach to the TPF has no detrimental effect on the flexion muscle strength and knee function. Level of Evidence Therapeutic Level IV.
Background and Objectives: This study was done to translate and evaluate the validity and reliability of the Persian version of the Sport Concussion Assessment Tool 5 (SCAT5) among Iranian martial arts athletes. Methods: Translation and adaptation were performed in several stages with the instructions provided by Beaton et al. A total of 86 Persian-speaking martial arts athletes (42 males and 44 females) participated in this study. Descriptive statistics were reported for all items of SCAT5. For determining construct validity, the correlations between items of the Persian version of the SCAT5 and the Beck Depression Inventory (BDI) were all reviewed. The reliability of the questionnaire was determined from two different aspects of test-retest reliability and internal consistency. Results: The processes of translation and cultural adaptation were done by maintaining cultural adaptation through replacing appropriate words and terms, and finding semantic and perceptual equivalents. There was a significant difference between the results of male and female participants. For components of the SCAT5 in comparison with BDI, Spearman rank-order correlation coefficient (rho) was moderate with the Persian version of BDI 0.57 (p<0.001) in terms of the number of symptoms and severity of symptoms 0.50 (p<0.001). Regarding the test-retest reliability, the Persian version of the SCAT5 questionnaire showed excellent reliability for all items (ICC>0.75) and moderate reliability for the number of symptoms (ICC=0.48) and severity of symptoms (ICC=0.49). The coefficient of Cronbach’s alpha was more than 0.70 for all items of the Persian version of the SCAT5. Conclusion: The Persian version of the SCAT5 is a valid and moderate reliable instrument for medical professionals and health care providers in concussion assessment. The ceiling effect was observed in three components, including orientation and two parts of concentration (backward recalling of digits+recalling of months in reverse order).
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